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OB GYNE 4 > 3 Maternal Testing Part 2 > Flashcards

3 Maternal Testing Part 2 Flashcards

1
Q

What does CVS stand for?

A

Chorionic villi sampling (CVS)

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2
Q

What are 2 exams performed for CVS

A

Transcervical

Transabdominal

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3
Q

Transcervical CVS is performed between __ and __ weeks

A

11 and 12.5 weeks

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4
Q

Catheter is inserted through cervix to the?

A

chorion frondosum

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5
Q

With ______________from syringe moving catheter back and forth will capture the chorionic villi cells.

A

negative pressure

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6
Q

With the transabdominal approach a needle passes through the ________to the chorion frondosum

A

abdomen

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7
Q

Performed when placenta cannot be accessed by Transcervical and can be done beyond

A

12.5 weeks

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8
Q

Method of transcervical or transabdominal depends on there the _____ lies

A

placenta (chorion frondosum)

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9
Q

More DNA is obtained from a ___ than a _____

A

CVS; amniocentesis

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10
Q

Which has Faster/earlier results a CVS or amniocentesis

A

CVS

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11
Q

CVS has 1/200 risk for

A

spontaneous abortion

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12
Q

CVS cannot detect NTD, but _____ & ____

A

Chromosomal abnormalities and DNA

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13
Q

CVS can cause(2)

A

PROM

infection

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14
Q

If CVS is positive patient sent for

A

genetic counselling

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15
Q

Amniocentesis uses the transabdominal approach (needle through moms abdomen) to look at ?

A

Amniotic fluid from amniotic sac

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16
Q

Amniocentesis detects (3)

A

chromosomal abnormalities
NTD
and some genetic disorders

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17
Q

Amniocentesis completed for 3 reasons

A

genetic testing
fetal lung testing
for treatment of ployhydramnios

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18
Q

The risks of Amniocentesis include (4)

A

Bleeding
PROM
Preterm labour
Club feet

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19
Q

When is optimal time to perform Amniocentesis?

A

16 weeks and onwards

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20
Q

What does the Radiologist need to know from us before performing an Amniocentesis (4)

A

of fetuses
position of fetuses
Placental location
Gestational age - BPD, HC, AC, FL

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21
Q

The _____ with ____ is taken before and after the procedure.

A

Heart rate; m mode

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22
Q

A limited anatomical survey is done before the Amniocentesis which includes

A

choroids, fetal heart, stomach, bladder, kidneys, spine, limbs

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23
Q

Amniocentesis is a sterile technique using (6)

A 
Needle (16,18,20 gage)
syringe
cleaning solution poured into vials (betadine brown) (alcohol pink)
Bx guide (biopsy guide for needle) 
sterile gel 
probe cover (all the way up the cord)
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24
Q

What is considered not sterile (2)

A

Sonographer and the machine

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25
Q

What artifacts can be seen with Amniocentesis that can distort the needle position

A

Refraction and reverberation

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26
Q

How many CC’s of amniotic fluid is aspirated into each syringe?

A

10 CC’s

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27
Q

The amniotic fluid is then emptied into 2______ vials

A

non sterile

28
Q

What are the difference types of Amniocentesis (4)

A

Cytogenetic Amniocentesis
O.DD (optical density Determination)
L/S Amniocentesis
Therapeutic

29
Q

Cytogenetic Amniocentesis is when _______ from the amniotic fluid is cultured for analysis.

A

fetal skin cells.

DNA and biochemistry (AFP) is looked at

30
Q

When can a Cytogenetic Amniocentesis be performed?

A

11 weeks to term

31
Q

Abnormalitites at ___ weeks will require a amnio for fetal chromosomes

A

18 week (detailed scan)

32
Q

Cytogenetic Amniocentesis is routinely done in these cases (3)

A

Late maternal age
Hx of congenital abnormality
previous pregnancy or direct relative

33
Q

Twin Amniocentesis uses dye to differentiate the 2 gestational sacs called.

A

INDIGO CARMINE* (TWIN A)

34
Q

If the doctor draws purple dye then they have pulled ?

A

Twin A

Non purple (Twin B)

35
Q

INDIGO CARMINE affects which blood levels in the amniotic fluid?

A

bilirubin levels

36
Q

O.DD (optical density Determination) measures _____ levels in ________ pregnancies

A

bilirubin

RH sensitized

37
Q

ODD is usually done in What trimesters?

A

Late 2nd and 3rd

38
Q

ODD is placed in a brown bottle because?

A

It is photosensitive

39
Q

What test looks at lung maturity?

A

L/S ratio

40
Q

What are the 2 surfactants of the lungs

A

Lecithin and Sphingomyelin

41
Q

What are surfactants responsible for?

A

Decrease in surface tension in the alveoli of the lungs

42
Q

Lecithin and Sphingomyelin are fairly equal in the amniotic fluid up to

A

33 weeks gestation

43
Q

After 33 weeks ______ increases significantly where ________ remains constant

A

Lecithin;Sphingomyelin

44
Q

If the L/S ratio is greater than 2:1 this means?

A

The lungs are considered mature

45
Q

L/S test is done in the ____trimester

A

3rd

46
Q

L/S is done when ?

A

Early delivery is elected by doctor or repeat c -Section

47
Q

Early birth can be caused by

A 
Gestational diabetes 
High blood pressure 
PROM
Placental insufficiency 
RH disease
48
Q

What test is done for polyhydramnios?

A

Therapeutic amniocentesis

49
Q

What does Therapeutic amniocentesis help with?

A

Pressure of the large uterus pressing on abdominal contents causing SOB

50
Q

Other reasons for Therapeutic amniocentesis

A

Can occur from Twin to twin transfusion and hydrops

Fluid will reaccumulate within days

51
Q

What does PUBS stand for?

A

Percutaneous umbilical blood sampling

52
Q

What is another name for PUBS?

A

CORDOCENTESIS*

53
Q

With the PUBS procedure a needle is put into the umbilical cord __to__cm from placenta insertion

A

2 to 3

54
Q

What is usually sampled the umbilical vein or the artery?

A

Vein

55
Q

The umbilical vein can be sampled in the?(3)

A

Liver
Heart
Or free floating

56
Q

PUBS is usually used after ___weeks to for genetic disorders and blood conditions

A

18

57
Q

Indications for PUBS

A 
Chromosomal analysis within 72 hours
Fetal blood gas sampling in IUGR fetuses
Fetal infections
FETAL ANEMIA IN RH SENSITIZATION
FETAL BLOOD TRANSFUSION VIA PUBS
Treat fetal arrhythmia with medications via PUBS
58
Q

Risk of PUBS

becoming more rare

A

Bleeding from puncture site
Infection
rupture of membranes

59
Q

What does FISH stand for?

A

Flouresence in Situ Hybridization

60
Q

What is FISH used for?

A

looks for how many copies are present for a specific chromosome.

61
Q

Which chromosomes does FISH look for

A

Trisomy, 13, 18, 21 x and y

62
Q

Which has less steps FISH or cytogenetic karotyping?

A

FISH

63
Q

FISH can be performed on which 3 things?

A

fetal blood
amniotic fluid
CVS

64
Q

is the results of FISH fast or slow?

A

FAST

65
Q

When there is a hole in the diaphragm (abdo contents moving into chest cavity pressing on the developing lungs) what is used to fix this?

A

Diaphragmatic hernia treatment

OB GYNE 4 (11 decks)

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